The islet transplantation site can be divided into two categories: orthotopic islet transplantation and ectopic islet transplantation. Orthotopic islet transplantation refers to that the insulin secreted and released from the transplanted islet will be metabolized into the liver through the hepatic portal vein system, which does not change the original insulin metabolic pathway, including the portal vein of the liver, the greater omentum. The insulin secreted by the ectopic islet transplantation changes the original metabolic pathway of insulin. The ideal islet transplantation site generally has the following characteristics: high success rate transplantation, high long-term survival rate of graft, simple operation, less trauma, less complications, low risk, easy to repeat detection and so on. This article provides a review of the current research status of each islet transplantation site, in order to provide reference for future related research.
目的 探讨幕上手术后远隔幕下部位出血的临床特点、发病原因、影像学表现及相关干预结果。 方法 分析2009年1月-2011年1月2例经幕上手术后出现远隔幕下部位出血的病例的临床资料。1例患者因颅内动脉瘤经翼点入路行动脉瘤夹闭术,术后出现远隔幕下部位出血;1例患者因硬膜下血肿行钻孔引流术,术后出现远隔幕下部位出血。 结果 2例幕上手术患者均在术中或(和)术后大量引流脑脊液,术后发生出血部位均位于远隔幕下,均行积极手术干预,恢复良好,格拉斯预后评分均为4分。 结论 过度引流可能为引起幕上手术后形成远隔幕下部位出血的主要原因,术前、术中、术后应给予高度重视,并通过少量间断引流脑脊液可以尽量避免发生。
目的探讨碘伏原液浸泡对于预防阑尾Ⅲ类手术切口手术部位感染(SSI)的疗效。 方法回顾性分析笔者所在医院2012年5月至2013年5月期间施行阑尾切除术者中切口类型为Ⅲ类的92例患者的临床资料,比较以碘伏原液浸泡切口(浸泡组)和冲洗切口(常规组)处理后患者的切口愈合情况。 结果术后常规组57例患者中,有43例切口愈合等级为甲级,5例为乙级,9例为丙级,SSI发生率为24.56%(14/57)。浸泡组35例患者的切口愈合均良好,均为甲级愈合,SSI发生率为0,低于常规组(P<0.05)。 结论采用碘伏原液浸泡切口5 min能有效预防阑尾炎Ⅲ类切口SSI的发生,值得临床推广应用。
【Abstract】ObjectiveTo investigate the effect of xenotransplantation of microencapsulated rabbit parathyroid tissue in different sites in rats for the treatment of hypoparathyroidism. MethodsThe parathyroid glands from Wistar rats were removed to make them aparathyroid. Ultimately, sixteen rats were included because their serum calcium values were continuously below 1.6 mmol/L. We also encapsulated the cultured rabbit parathyroid tissue with alginateBaCl2 microcapsule. According to the transplantation sites, rats were randomly divided into two groups: renal adipose microcapsule group and peritoneal microcapsule group, eight in each group. Encapsulated rabbit parathyroid tissues were then transplanted accordingly to different microcapsule groups. The calcium serum contents were examined on 5,15,25,35,45,55 and 65 d respectively after transplantation and the grafts were observed through electron microscope on the 65 d in particular. ResultsThe calcium contents after transplantation in renal adipose microcapsule group restored to normal and the observation outcomes of grafts showed that they survived well. The calcium contents of posttransplantation in peritoneal group also restored to normal with an exception that it dropped to a level lower than 1.6 mmol/L on the 65 d. Electron microscope also showed that there were necrotic tissues in the center and only a few cells survived on the edge of the grafts. Within peritoneal microcapsule group, the values were significantly lower than others taken at different phases. ConclusionMicroencapsulated rabbit parathyroid tissue that was xenotransplanted into rats can survive and function without administration of immunodepressant. There are significant differences of calcium contents at varying phases between two transplantation sites, which demonstrate that renal adipose may be an optimal site for microcapsule xenotransplantation.
Objective To explore the relationship between the metastatic sites and prognosis in newly diagnosed stage Ⅳ breast cancer. Methods The data of newly diagnosed female patients with stage Ⅳ invasive breast cancer with complete follow-up data from SEER database from 2010 to 2015 were grouped according to different metastatic sites, and the differences of breast cancer-specific survival (BCSS) in different metastatic sites were analyzed by univariate and multivariate Cox. Kaplan-Meier method was used to draw the survival curve, and log-rank test was used to analyze the prognostic factors of BCSS in newly diagnosed stage ⅳ breast cancer. Results A total of 8 407 patients were included in the final analysis. Among them, 5 619 (66.84%) patients were confirmed with bone metastasis only, 1 483 (17.64%) patients with lung metastasis only, 1 096 (13.04%) patients with liver metastasis only, and 209 (2.49%) patients with brain metastasis only. The median follow-up time was 22 months, with 4 180 (49.72%) breast cancer-related deaths and a median BCSS of 39 months in those patients. The location of metastasis in newly diagnosed stage Ⅳ invasive breast cancer was significantly correlated with BCSS (χ2=151.07, P<0.001). Multivariate Cox model analysis showed that the BCSS was worse in patients with liver metastasis [HR=1.34, 95%CI (1.21, 1.49), P<0.001], lung metastasis [HR=1.09, 95%CI (1.04, 1.14), P<0.001] and brain metastases [HR=1.28, 95%CI (1.20, 1.36), P<0.001] than in patients with bone metastases. Further subgroup analysis showed that the BCSS of breast cancer patients with different molecular subtypes and different metastatic sites were also significantly different (P<0.05). Patients with brain and liver metastases in the HR+/HER2– subtype had worse BCSS than those with bone metastases (P<0.001). Patients with brain metastases in the HR+/HER2+ subtype had worse BCSS than those with bone metastases (P=0.001). In HR–/HER2+ subtype, the BCSS of patients with liver metastasis, lung metastasis and brain metastasis were worse than that of patients with bone metastasis (P<0.05). In HR–/HER2– subtype, the BCSS of patients with brain metastasis and liver metastasis were worse than that of patients with bone metastasis (P<0.05) . Conclusion The prognosis of newly diagnosed stage ⅳ breast cancer patients with different metastatic sites is different, and the prognosis of different molecular subtypes and different metastatic sites is also different.
目的 通过对1例原发于宫颈的胎盘部位滋养细胞肿瘤(PSTT)的资料及相关文献的复习,全面介绍胎盘部位滋养细胞肿瘤的临床特征、病理特点、治疗方式及预后。 方法 对收治1例罕见原发于宫颈部位的PSTT的临床病理资料进行分析,并以“胎盘部位滋养细胞肿瘤”为主题词查阅中国知网(CNKI)及PubMed等文献数据库进行文献复习。 结果 该例原发于宫颈部位的PSTT患者术后化学疗法后,目前情况良好,已随访3年,无复发及转移征象。2011年9月1日前,CNKI数据库共报道300余例PSTT病例,PubMed数据库共160余例,其中有2例原发于宫颈部位的PSTT。原发于宫颈部位的PSTT罕见,易误诊,往往需要宫颈活组织检查或宫颈搔刮才能确诊。 结论 原发于宫颈部位的PSTT的预后是否遵循PSTT尚需收集更多的病例证实。PSTT因其发病率低,临床表现多无特异性,通常需要通过诊断性刮宫、活组织检查甚至术后病理检查才能确诊。PSTT首选的治疗方式为手术,多数患者病灶清除后可治愈,对有高危因素的患者术后宜选择依托泊苷+甲氨蝶呤+放线菌素D+环磷酰胺+长春新碱(EMA-CO)方案或依托泊苷+甲氨蝶呤+放线菌素D+依托泊苷+顺铂(EMA-EP)方案进行化学治疗,以期改善预后。
Mental rotation cognitive tasks based on motor imagery (MI) have excellent predictability for individual’s motor imagery ability. In order to explore the relationship between motor imagery and behavioral data, in this study, we asked 10 right-handed male subjects to participate in the experiments of mental rotation tasks based on corresponding body parts pictures, and we therefore obtained the behavioral effects according to their reaction time (RT) and accuracy (ACC). Later on, we performed Pearson correlation analysis between the behavioral data and the scores of the Movement Imagery Questionnaire-Revised(MIQ-R). For each subject, the results showed significant angular and body location effect in the process of mental rotation. For all subjects, the results showed that there were correlations between the behavioral data and the scores of MIQ-R. Subjects who needed the longer reaction time represented lower motor imagery abilities in the same test, and vice versa. This research laid the foundation for the further study on brain electrophysiology in the process of mental rotation based on MI.